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World J Gastroenterol. Oct 28, 2014; 20(40): 14598-14614
Published online Oct 28, 2014. doi: 10.3748/wjg.v20.i40.14598
Hepatitis B virus coinfection in human immunodeficiency virus-infected patients: A review
Hsin-Yun Sun, Wang-Huei Sheng, Mao-Song Tsai, Kuan-Yeh Lee, Sui-Yuan Chang, Chien-Ching Hung
Hsin-Yun Sun, Wang-Huei Sheng, Chien-Ching Hung, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10617, Taiwan
Mao-Song Tsai, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
Kuan-Yeh Lee, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu 30059, Taiwan
Sui-Yuan Chang, Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei 10617, Taiwan
Sui-Yuan Chang, Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 10617, Taiwan
Chien-Ching Hung, Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40447, Taiwan
Author contributions: Sun HY, Sheng WH, Tsai MS, Lee KY, Chang SY, and Hung CC performed the literature search and review, and wrote the paper; Chang SY and Hung CC edited and revised the manuscript.
Supported by Centers for Disease Control, Taiwan, Grant No. DOH 102-DC-1401
Correspondence to: Chien-Ching Hung, MD, PhD, Clinical Associate Professor, Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei 10617, Taiwan. hcc0401@ntu.edu.tw
Telephone: +886-2-23123456 Fax: +886-2-23707772
Received: November 14, 2013
Revised: December 24, 2013
Accepted: April 27, 2014
Published online: October 28, 2014
Processing time: 349 Days and 7 Hours
Abstract

Hepatitis B virus (HBV) infection is a leading cause of chronic hepatitis, liver cirrhosis, and hepatocellular carcinoma worldwide. Due to the shared modes of transmission, coinfection with HBV and human immunodeficiency virus (HIV) is not uncommon. It is estimated that 10% of HIV-infected patients worldwide are coinfected with HBV. In areas where an HBV vaccination program is implemented, the HBV seroprevalence has declined significantly. In HIV/HBV-coinfected patients, HBV coinfection accelerates immunologic and clinical progression of HIV infection and increases the risk of hepatotoxicity when combination antiretroviral therapy (cART) is initiated, while HIV infection increases the risk of hepatitis events, cirrhosis, and end-stage liver disease related to chronic HBV infection. With the advances in antiviral therapy, concurrent, successful long-term suppression of HIV and HBV replication can be achieved in the cART era. To reduce the disease burden of HBV infection among HIV-infected patients, adoption of safe sex practices, avoidance of sharing needles and diluent, HBV vaccination and use of cART containing tenofovir disoproxil fumarate plus emtricitabine or lamivudine are the most effective approaches. However, due to HIV-related immunosuppression, using increased doses of HBV vaccine and novel approaches to HBV vaccination are needed to improve the immunogenicity of HBV vaccine among HIV-infected patients.

Keywords: Viral hepatitis; Seroepidemiology; Sexually transmitted diseases; Nucleoside reverse-transcriptase inhibitor; Vaccination

Core tip: We provide an updated review of hepatitis B virus (HBV) coinfection among human immunodeficiency virus (HIV)-infected patients, focusing on the epidemiology, management and prevention of HBV infection. The mutually detrimental interactions between HBV and HIV are discussed. Three updated treatment guidelines for the management of patients with HIV/HBV coinfection are summarized. We also review the published data on the effectiveness or efficacy of HBV vaccination studies, with emphasis on the different approaches to improvement of the serologic responses to conventional HBV vaccine among HIV-infected patients.